Reviews about Using Prosody to Treat Other Skills

Last update:  September 1,  2021

USING PROSODY TO TREAT NONPROSODIC TARGETS

  1. Full reviews can be accessed by clicking on (or cutting and pasting) the address at the end of each summary.
  2. This table can be used to locate reviews about different interventions in which prosody is used to treat nonprosodic target outcomes.
  3. Scroll down to the outcome that you are interested in treating.
  4. The table is organized by outcomes which include
  • ACADEMIC OUTCOMES
  • ACCENTEDNESS OUTCOMES
  • AFFECT (nonprosodic aspects of affect) OUTCOMES
  • ARTICULATION/SPEECH SOUND OUTCOMES (see also Phonological Outcomes)
  • ATTENTION OUTCOMES
  • CHALLENGING BEHAVIOR OUTCOMES
  • COGNITION OUTCOMES
  • COMPREHENSIBILITY (EASE OF UNDERSTANDING)
  • COMPREHENSION OUTCOMES
  • CONFIDENCE OUTCOMES
  • EFFECTIVENESS OUTCOMES
  • FLUENCY/STUTTERING OUTCOMES
  • FUNCTIONAL USE OF WORDS OUTCOMES
  • GENERAL COMMUNICATION SKILLS/FORMAL TEST OUTCOMES
  • GESTURING OUTCOMES
  • IMITATION OUTCOMES
  • INITIATION OF SPEAKING TURNS/CONVERSATION OUTCOMES
  • INTELLIGIBILITY OUTCOMES
  • INTERACTION OUTCOMES
  • LANGUAGE DEVELOPMENT–GENERAL
  • LITERACY OUTCOMES
  • MEMORY OUTCOMES
  • MLU/WORDS PER MINUTE OUTCOMES
  • MOTOR SKILLS
  • MORPHOSYNTAX OUTCOMES
  • NAMING (see  Functional Use of Words and/or Production of Words)
  • NARRATION (Story Telling/Retelling)
  • NORMALCY/NATURALNESS OUTCOMES
  • ON-TASK BEHAVIOR OUTCOMES
  • ORAL MOTOR SKILL OUTCOMES
  • PHONOLOGICAL/PHONOLOGICAL PROCESSES OUTCOMES (see also Articulation Outcomes)
  • PICTURE DESCRIPTION OUTCOMES
  • POINTING OUTCOMES
  • PRAGMATIC OUTCOMES
  • PRODUCTION OF PHRASES OUTCOMES
  • PRODUCTION OF WORDS OUTCOMES
  • PSYCHOLOGICAL STATUS OUTCOMES
  • RATE OF VERBALIZATION OUTCOMES
  • READING (see LITERACY)
  • REPETITIVENESS OUTCOMES
  • RESONANCE OUTCOMES
  • RESPIRATION OUTCOMES
  • RESPONDING TO QUESTIONS/COMMANDS OUTCOMES
  • SEMANTICS OUTCOMES
  • SINGING OUTCOMES
  • SOCIAL INTERACTION OUTCOMES
  • SPEECH SOUND OUTCOMES (see Articulation/Speech Sound Outcomes and Phonological/Phonological Processes Outcomes)
  • TURN TAKING OUTCOMES
  • VERBAL EXPRESSION OUTCOMES
  • VERBAL REPAIRING OUTCOMES
  • VOCALIZATION OUTCOMES
  • VOICE QUALITY OUTCOMES
  • VOICE ONSET TIME OUTCOMES
  • WORD/SOUND DISCRIMINATION OUTCOMES
  • WORD FINDING OUTCOMES

___________________________________________________

ACADEMIC OUTCOMES

___________________________________________________

Limited Evidence

______________________________________________________

ACCENTEDNESS OUTCOMES

______________________________________________________

Moderate Evidence

__________________________________________________________

AFFECT (nonprosodic aspects of affect) OUTCOMES

_________________________________________________________

 Strong Evidence

  • The results of single subject experimental design studies indicated that both cognitive-linguistic and imitative intervention approaches were effective in improving the rate of correct productions of 3 affects/emotions: happy, sad, angry. The investigators provided thorough descriptions of both intervention procedures as well as the participant characteristics (Rosenbek et al., 2007). Expressive Aprosodia, Right Hemisphere Brain Damage; Adults https://clinicalprosody.wordpress.com/2015/01/21/rosenbek-et-al-2004/
  • Five multiple baseline across participants experimental design single case investigations explored the effectiveness of administering Rapid Syllable Transitions (ReST) treatment via teletherapy. Each of the participants made progress on imitation tasks in which the target response was correct production of speech sounds (Thomas et al., 2016). Childhood Apraxia of Speech; Adultshttps://clinicalprosody.wordpress.com/2020/06/25/thomas-et-al-2016/

Moderate Evidence

  • Using single-subject experimental design studies explored, the effectiveness of across-modal matching to sample intervention to improve the comprehension of affective prosody of Japanese children diagnosed was confirmed (Matsuda & Yamamoto, 2013.) Autism Spectrum Disorders; Children https://clinicalprosody.wordpress.com/2015/01/29/matsuda-yamamote-2013/
  • Single subject experimental design investigations revealed that a computer based intervention administered by a “tutor” was associated with moderate improvements on formal tests of facial affect recognition. There only was limited support for generalization to social interaction with peers (Lacava et al., 2010.) Autism Spectrum Disorders; Children https://clinicalprosody.wordpress.com/2015/02/28/lacava-et-al-2010/ 

Fair Evidence

______________________________________________________

ARTICULATION/SPEECH SOUND OUTCOMES*

*(see also Phonological/Phonological Processes Outcomes)

______________________________________________________

Strong Evidence

  • Both Rapid Syllable Transition Treatment, and the Nunffield Dyspraxia Programme-Third Edition resulted in significant improvements in outcomes related to correct speech sound production, articulatory groping, and articulatory consistency (Murray et al., 2015.) Childhood Apraxia of Speech; Children clinicalprosody.wordpress.com/2017/08/21/murray-et-al-2015/
  • This single subject experimental design provides support for the effectiveness of a lengthy program of treatment to improve target syllables to the beat of a metronome (Dworkin et al., 1988.)   Apraxia; Adult https://clinicalprosody.wordpress.com/2013/07/18/dworkin-et-al-1988

Moderate Evidence

  • Three of four single subject experimental design investigations resulted in overall improvement of the production of speech targets. The perceptual measure involved a combination of speech sounds, lexical stress, segmentation/concordance (Maas & Farinella, 2012). Childhood Apraxia of Speech; Children https://clinicalprosody.wordpress.com/2014/08/12/maas-farinella-2012/
  • This research provides moderate support for a computer-based intervention for moderate to strong improvement of vowel duration (Thomas-Stonell et al., 1991.) Neurological Impairment; Children, Adolescent https://clinicalprosody.wordpress.com/2013/05/19/thomas-stonell-et-al-1991
  •  This single-case experimental design investigation involved 6 children between the ages 8 and 16 years who had been diagnosed with childhood apraxia of speech (CAS). The results of 6 single-case experimental design investigations revealed that variable practice in the form of modulated prosody can increase speech sound performance compared to interventions without prosodic variability when the metric was mean effect size (Preston et al. 2017).  Childhood Apraxia of Speech; Children. https://clinicalprosody.wordpress.com/2020/02/25/preston-et-al-2017/
  • A Systematic Review revealed that articulatory accuracy improved in interventions involving prosody (Ballard et al., 2015.) Apraxia of Speech; Adults https://clinicalprosody.wordpress.com/2017/06/30/ballard-et-al-2015/
  • This preliminary investigation explored the effectiveness of ultrasound biofeedback paired with prosodic manipulation in improving the speech sound production of 9- to 15-year-old children diagnosed with CAS using a multiple baseline across behaviors experimental design. Six children participated in the investigation. All the participants (Ps) displayed at least some improvement in their ability imitate targeted sound sequences over the course of the 18-session program
    (Preston et al., 2013). Childhood Apraxia of Speech; Children.

     

  • Auditory-motor mapping training(AMMT) was found to have potential for success in improving speech sound production in three studies:  Proof of Concept, Replication, and Comparison. This investigation is listed in 2 grade categories because each of the studies was reviewed individually resulting in differences in the Assigned Overall Grade of External Evidence (Chenausky & Schlaug, 2018.) Autism Spectrum Disorder; Children https://clinicalprosody.wordpress.com/2018/04/29/chenausky-schlag-2018/

Fair Evidence

  • The two critically reviewed sources reported immediate (within a week of the termination of therapy) improvement in articulatory production of trained targets for both Melodic Intonation Therapy (MIT) and Rhythmic Therapy (RT.) One study that explored immediate generalization to untrained targets indicated MIT was superior to RT but the other did not.One source that explored maintenance indicated MIT and RT results were similar (Watson, 2106.) Aphasia (nonfluent); Adults  https://clinicalprosody.wordpress.com/2018/07/25/watson-2016/
  • Overall results of 2 Experiments involved French children diagnosed with reading impairments treated with Cognitive-Musical Training (CMT) indicated at improvement in some measures of categorical perception (Habib et al., 2016.) Literacy Problems; Children  https://clinicalprosody.wordpress.com/2017/03/12/habib-et-al-2016/
  • Of the 5 investigations that involved prosody or prosodic outcomes in this Systematic Review, 2 focused on consonant and vowel production as an outcome. One of the consonant and vowel investigations reported progress (Mahoney, 2015.) CAS; Children https://clinicalprosody.wordpress.com/2018/02/08/mahoney-2015/
  • Limited support for a 4-year long program of intervention in improving articulation (Puyuelo & Rondal, 2005.) Cerebral Palsy; Children  https://clinicalprosody.wordpress.com/2013/07/23/puyuelo-rondal-2005/
  •  Investigators reviewed music therapy (MT) sessions describing the effectiveness of 7 MT techniques for improving prosody. Overall, gains from the 12 session course of treatment for the articulation outcome ranged from minimal to moderate (Kim & Tomaino, 2008.) Nonfluent Aphasia; Adults https://clinicalprosody.wordpress.com/2018/01/29/kim-tomaino-2008/
  • Auditory-motor mapping training (AMMT) was found to have potential for success in improving speech sound production in three studies:  Proof of Concept, Replication, and Comparison. This investigation is listed in 2 grade categories because each of the studies was reviewed individually resulting in differences in the Assigned Overall Grade of External Evidence (Chenausky & Schlaug, 2018.) Autism Spectrum Disorder; Children https://clinicalprosody.wordpress.com/2018/04/29/chenausky-schlag-2018/

Limited Evidence

  • Use of visual (oscilloscope and intraoral pressure) feedback shows promise for increasing normalcy ratings of some (but not all) Ps’ articulatory precision (Caligiuri & Murry, 1983.) Dysarthria; Adult https://clinicalprosody.wordpress.com/?s=Caligiuri 
  • These case studies provided variable support for an intervention to improve contrastive stress, voice quality (pitch and loudness), articulatory precision, and naturalness but not verbal repairing in speakers with MS (Hartelius et al., 1997.) Multiple Sclerosis; Adult https://clinicalprosody.wordpress.com/?s=Hartelius

Limited Evidence

  • This Narrative (or Traditional) review of the literature contains reviews of several investigations suggesting that the inclusion of music/singing in intervention directed toward the production of speech sounds can be associated with improvement (Michel & May, 1974.) General Language Impairment; Children https://clinicalprosody.wordpress.com/2016/04/27/michel-may-1974/
  •  This single case study investigated the effect of an adapted form of Melodic Intonation Therapy (AMIT) on a patient (P) with Broca’s Aphasia who was a speaker of Brazilian Portuguese. The investigators monitored 73 outcomes. The outcomes associated with apraxia of speech improved (da Fontoura et al., 2014.) Aphasia, Adults  https://clinicalprosody.wordpress.com/2016/12/05/da-fontoura-et-al-2014/
  • Illustrative case studies provide initial limited support for the use of modified melodic intonation (MIT) therapy in conjunction with other speech therapies to increase production of correct consonants as well as accuracy of articulatory sequences (Helfrich-Miller, 1994.) Childhood Apraxia of Speech; Child https://clinicalprosody.wordpress.com/2013/10/27/helfrich-miller-1994/
  • This case study of an Iranian patient (P) describes the speech characteristics of Wilson’s disease. The investigators also describe a two-year course of treatment that that they claimed resulted improved speech sound production (Farazi et al., 2018.) Dysarthria (Wilson’s Disease); Adults https://clinicalprosody.wordpress.com/2020/10/20/farai-et-al-2018/ 
  • Illustrative case studies provide variable support for the use of modified melodic intonation (MIT) therapy in conjunction with other speech therapies to generalize acquired speech sounds to conversation (Helfrich-Miller, 1994.) Childhood Apraxia of Speech; Children https://clinicalprosody.wordpress.com/2013/10/27/helfrich-miller-1994/
  • This traditional narrative review provides a guide to incorporating Lee Silverman Voice Treatment (LVST-Loud) into telepractice and reviews research documenting its effectiveness for articulatory precision as well as its costs and P satisfaction (Theodoros & Ramig, 2011) Parkinson’s Disease; Adults https://clinicalprosody.wordpress.com/2014/05/23/theodoros-ramig-2011

Minimal Evidence

  • These case studies yielded minimally applicable clinical results because the sessions were very brief. The perceptual measures of clear articulation improved following both interventions—Lee Silverman Voice Treatment and intonation only therapy (Kobayashi et al., 2004.) Dysarthria; Adult https://clinicalprosody.wordpress.com/2013/11/13/kobayashi-et-al-2004/
  • This single case study revealed that a combined intervention in which Melodic Intonation Therapy followed by a course of the Touch-Cue Method resulted in improved speech accuracy in a Finnish-speaking 4-year-old child (Martikainen & Korpilahti, 2011.) Childhood Apraxia of Speech; Children clinicalprosody.wordpress.com/2017/11/15/martikainen-korpilahti-2011/

No Intervention Evidence Provided

  • This blog post briefly describes activities that speech language pathologists (SLPs) can use to integrate prosody into interventions for children with Childhood Apraxia of Speech (CAS.)  Some of the activities include music (Stoeckel, 2016.)  Childhood Apraxia of Speech; Children  https://clinicalprosody.wordpress.com/2018/08/14/stoeckel-2016/ 

Evidence contraindicates the use of the intervention for the specific outcome(s)

___________________________________________________________

ATTENTION OUTCOMES

____________________________________________________________

Moderate Evidence

  • This investigation demonstrates the effectiveness music therapy in improving attention in developmentally delayed children from Taiwan who were speakers of Mandarin Chinese (Lee, 2008). Speech Impairment, Language Impairment, Developmental Delay; Children https://clinicalprosody.wordpress.com/2014/07/23/lee-2008/

Fair Evidence

Limited Evidence

  • This Narrative (or Traditional) review of the literature contains reviews of several investigations suggesting that the inclusion of music/singing in intervention directed toward attention can be associated with improvement (Michel & May, 1974.) General Language Impairment; Children https://clinicalprosody.wordpress.com/2016/04/27/michel-may-1974/

Contraindicated by the Evidence

  • Overall results of 2 Experiments involved French children diagnosed with reading impairments treated with Cognitive-Musical Training (CMT) indicated no significant improvement in measures of visuo-spatial attention (Habib et al., 2016.) Literacy Problems; Children  https://clinicalprosody.wordpress.com/2017/03/12/habib-et-al-2016/

___________________________________________________________

CHALLENGING BEHAVIOR OUTCOMES

____________________________________________________________

Moderate Evidence

Fair Evidence

_________________________________________________________________

COGNITION OUTCOMES

________________________________________________________________

Moderate Evidence

Fair Evidence

__________________________________________________________

COMPREHENSIBILITY (EASE OF UNDERSTANDING) OUTCOMES

__________________________________________________________

Moderate Evidence

  • Four single-subject experimental design investigations revealed that ratings of ease of understanding (comprehensibility) improved following the treatment that included both prosody and segmental targets (Behrman, 2014.) Second (or more) Language Learner; Adult https://clinicalprosody.wordpress.com/2015/02/11/behrman-2014/

Fair Evidence

______________________________________________________________

COMPREHENSION OUTCOMES

____________________________________________________________ 

Moderate Evidence

  • Moderate improvement in comprehension of read stories during expressive storybook reading, as assessed using cued recall. This is not an intervention study but it is clinically related (Mira & Schwanenflugel, 2013.) Typically Developing; Children https://clinicalprosody.wordpress.com/2013/12/27/592/
  • This meta-analysis describes sources that support the effectiveness of music therapy (pitch and rhythm) for the moderately strong improvement of correct responses to directions involving shapes (Whipple, 2004.) Autism; Children https://clinicalprosody.wordpress.com/2014/03/01/whipple-2004/
  • The results of this investigation that compared a control intervention and two experimental interventions (implicit and explicit instruction in prosody awareness) revealed that the explicit intervention yielded significantly higher scores on tests of the comprehension of English than either the implicit or control interventions for students in Iran who were training to be Farsi-English interpreters (Yenkimaleki, 2017.)  English Language Learner; Adult  https://clinicalprosody.wordpress.com/2018/11/26/yenkimaleki-2017/ 
  • This comparison study (i.e., not an intervention study) indicates that slowed speaking rate can result in improved comprehension of novel target words (Ellis Weismer & Hesketh (1993.) Specific Language Impairment; Children https://clinicalprosody.wordpress.com/2013/11/26/ellis-weismer-hesketh-1993/
  • This review investigated the reasons for using music therapy (MT) for improving communication development of children (ages 0 to 8 years) diagnosed with Autism Spectrum Disorder (ASD). One of the uses of MT was to improve receptive language (Vaiouli & Andrews, 2018.Autism Spectrum Disorder; Children  https://clinicalprosody.wordpress.com/2019/02/13/vaiouli-andrews-2018/

Fair Evidence

  • This meta-analysis describes sources that support the effectiveness of music therapy (pitch and rhythm) for small improvements in responding to directions involving gross motor tasks of challenging behaviors (Whipple, 2004.) Autism; Children https://clinicalprosody.wordpress.com/2014/03/01/whipple-2004/
  • This investigation provides only limited support for the use of Music Therapy in conjunction with speech-language therapy to improve comprehension (Groß et al., 2010.) Delayed Speech; Children clinicalprosody.wordpress.com/2013/09/26/gros-linder-ostermann-2010/
  • Second-grade English language learners were treated with one of four story-based interventions that compared music versus speech as a presentation strategy and illustrations versus no illustrations as extralinguistic support. There were no significant differences in receptive vocabulary scores between music versus speech and the illustration versus no illustration contexts suggesting that music-based stories yields gains similar to speech based stories (Medina, 1990.) Second Language Learners; Children https://clinicalprosody.wordpress.com/2017/12/27/medina-1990/
  • The results of this small group investigation suggest that a music-based intervention to improve expressive language in preschool children was successful in improving RECEPTIVE vocabulary scores (Hoskins, 1988). Cognitive Impairment, Developmental Delay; Children-preschool https://clinicalprosody.wordpress.com/2015/10/16/hoskins-1988/

Limited evidence

  • This is a case study of a patient diagnosed with aphasia and apraxia 10 years prior to the investigation. The results reveal that a modified version of Melodic Intonation Therapy was successful in improving some outcomes associated with comprehension as well as several measures of expressive language. (Slavin & Fabus, 2018.) Aphasia, Apraxia https://clinicalprosody.wordpress.com/2019/10/09/slavin-fabus-2018/

Contraindicated

  •  This single case study investigated the effect of an adapted form of Melodic Intonation Therapy (AMIT) on a patient (P) with Broca’s Aphasia who was a speaker of Brazilian Portuguese. The investigators monitored 73 outcomes. comprehension outcomes did not improve tended as they were concerned with skills not targeted by AMIT such as comprehension of words, directions, or Inferences (da Fontoura et al., 2014.) Aphasia, Adults https://clinicalprosody.wordpress.com/2016/12/05/da-fontoura-et-al-2014/

________________________________________________________________

CONFIDENCE OUTCOMES

________________________________________________________________ 

Limited Evidence

Contraindicated

  • The results of this case study suggest a combined intervention (Lee Silverman Voice Treatment and the Ryan Fluency Program) was moderately successful in improving severity and intelligibility as well as diadokokenesis skills. However, the patient’s self-perception of his communication skills decreased markedly (McMicken et al., 2011). Ataxic Dysarthria; Adult https://clinicalprosody.wordpress.com/2014/08/16/mcmicken-et-al-2011/

______________________________________________________________

EFFECTIVENESS OUTCOMES

_____________________________________________________________

Moderate Evidence

  • Participants’ (Ps’) who received an extended version of Lee Silverman Voice Treatment  (LVST) did not evidence a significant improvement self- ratings (as a group) on the Voice Handicap Index.  However, some of the individual Ps did improve significantly from pre to post treatment. In addition, judges’ rating of the quality of the Ps’ speech revealed that Ps who received the extended version of LSVT and those who received traditional LSVT were judged to be significantly better communicators that Ps who did not receive treatment (Spielman et al., 2007).Parkinson’s disease; Adults  https://clinicalprosody.wordpress.com/2019/02/27/spiel-man-et-al-2007/ 

Fair Evidence

  • This preliminary report suggests that both suggesting that both Lee Silverman Voice Treatment (LSVT) and Traditional therapy are associated in improvement perceived effectiveness outcomes for children with dysarthria associated with cerebral palsy (Levy et al., 2012).  Cerebral Palsy, Dysarthria; Children https://clinicalprosody.wordpress.com/2019/05/13/levy-et-al-2012/
  • This single group investigation provides initial, limited support for the effectiveness of a systems approach for improving participants’ perceptions of the effectiveness of the intervention (Pennington et al., 2010.) Cerebral Palsy; Adolescents https://clinicalprosody.wordpress.com/2013/09/03/pennington-et-al-2006/
  •  The investigators explored the changes in fundamental frequency, pitch range, voice quality, and perceptions of effectiveness of hormone therapy administered to transgender males. Although there was individual variation and overall participants tended to produce lower pitch levels indicating a deepening of their voices, perception of change was not highly correlated with acoustic measures. (Hancock et al., 2017.) Transgender males; adults clinicalprosody.wordpress.com/2017/12/12/hancock-et-al-2017/

Limited Evidence

––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––––

EYE CONTACT OUTCOMES

–––––––––––––––––––––––––––––––––––––––––––––––––––––––––––

Moderate Evidence

Limited Evidence

  • The authors provide objectives and strategies for clinicians wishing to include music in their treatment of children in the early stages of communication development. They report marked increase in eye contact (Witt & Steele, 1984.) Developmental Delay; Children https://clinicalprosody.wordpress.com/2016/10/13/witt-steele-1984/
  • This descriptive case study describes a music therapy based intervention in which by following the child’s lead he was able to help the child establish a link between the child’s actions and the music played by the music therapist and eventually establish eye contact and beginning forms of interpersonal communication (Saperston, 1973). Autism Spectrum Disorders, Developmental Delay; Children https://clinicalprosody.wordpress.com/2015/01/13/saperston-1973/

________________________________________________________________

FLUENCY/STUTTERING OUTCOMES

______________________________________________________________

Moderate Evidence

Limited  Evidence

  • This case study explored the effectiveness of music in stuttering therapy. There was limited improvement in the overall measures of stuttering and variable changes in frequency and type of disfluences. For reading aloud, there was limited improvement in the rate of disfluencies and variable changes in the type of disfluency (Baumann & Palasik, 2017.) Stuttering; Adults https://clinicalprosody.wordpress.com/2017/05/28/baumann-palasik-2017/

_________________________________________________________

FUNCTIONAL USE OF WORDS OUTCOMES

___________________________________________________________

 Moderate Evidence

Limited Evidence

__________________________________________________________

GENERAL SKILLS (including test instruments) OUTCOMES

___________________________________________________________

Moderate Evidence

  • Variable responses to tests of nonprosodic aspects of affect and psycho-emotional functioning (Bornhofen & McDonald, 2008.) Traumatic Brain Injury; Adults https://clinicalprosody.wordpress.com/2013/06/07/bornhofen-mcdonald-2008/
  • This meta-analysis describes a source that supports the effectiveness of music therapy (pitch and rhythm) for large improvements in performance on the Peabody Picture Vocabulary Test (Whipple, 2004.) Autism; Children https://clinicalprosody.wordpress.com/2014/03/01/whipple-2004/
  • This Systematic Review (SR) with broad criteria is concerned with a variety of treatments and outcomes. The authors of the SR rated sources for quality of certainty of results. The source that targeted performance on the PICAC (imitation, naming) was rated as Preponderant (Murray et al., 2014.) Childhood Apraxia of Speech; Children https://wordpress.com/post/clinicalprosody.wordpress.com/1329
  • The evidence was fair to weak but the program shows promise to improve self-rating on a communication adequacy questionnaire (McDonald et al., 2012.) Nonprogresssive Brain Injury, Affect Comprehension; Adult https://clinicalprosody.wordpress.com/?s=McDonald
  • This finding provide preliminary support for the effectiveness of Modified Melodic Intonation Therapy over  2 treatment sessions. The results indicated that MMIT but not the Control group (no treatment) evidenced more improvement on aspects of a investigator-designed test base on the Western Aphasia Battery (Conklyn et al., 2012). Aphasia, Nonfluent; Adults https://clinicalprosody.wordpress.com/2019/07/19/conklyn-et-al-2012/

Fair Evidence

  • This case study provides limited support for an intervention which involves explicit prosodic targets and meta-awareness procedures in improving receptive and expressive performance on the Prosodic Protocol (Bellon-Harn, 2011.) Prosodic Problems, Adolescent https://clinicalprosody.wordpress.com/2012/11/20/bellon-harn-2011

Limited Evidence

  • This case study described a case in which a woman with aphasia and apraxia profited from the addition of singing into her therapy programming when traditional therapy had failed. Evidence of progress took the form of improved performance on the Profile of Communicative Ability (Keith & Aronson, 1974.) Apraxia, Aphasia; Adults https://clinicalprosody.wordpress.com/2016/09/30/1340
  • These case studies provide limited support for using Melodic Intonation Therapy (MIT) as a warm-up prior to traditional therapy session to improve performance on some subtests of Porch Index of Communicative Ability in Children (Krauss & Galloway, 1982.) Expressive Language Delay and Childhood Apraxia of Speech; Children https://clinicalprosody.wordpress.com/2013/06/23/krauss-galloway-1982/
  • The results of this case study suggest a combined intervention (Lee Silverman Voice Treatment and the Ryan Fluency Program) was moderately successful in decreasing severity rating in a boxer with ataxic dysarthria. However, the patient’s self-perception of his communication skills decreased markedly (McMicken et al., 2011). Ataxic Dysarthria; Adult https://clinicalprosody.wordpress.com/2014/08/16/mcmicken-et-al-2011/
  • One P (of 4) who received traditional MIT did not evidence improvement on Porch Index of Communicative Abilities (PICA) scores from pre to post intervention; however, he did produce noticeable improvement on PICA modality scores and on cell scores as well as improvement on PICA scores 3 and 6 months post intervention. Three other Ps received a modification of MIT. Individual Ps’ change in overall PICA scores ranged from no to moderate improvement (Marshall & Holtzapple, 1978.) Aphasia, Apraxia; Adults https://clinicalprosody.wordpress.com/2016/10/31/marshall-holtzapple-1978
  • The investigator provides a clear description of music activities designed to facilitate spontaneous communication in preschoolers diagnosed as speech delayed. However there are some problems with this investigation comparing progress on a standardized test for Music Therapy and Speech Therapy with speech delayed preschoolers (Seybold, 1971). Speech Delay/Disorder General; Children https://clinicalprosody.wordpress.com/2014/10/06/seybold-1971/
  • This is a case study of a patient diagnosed with aphasia and apraxia 10 years prior to the investigation. The results reveal that a modified version of Melodic Intonation Therapy was successful in improving an outcome associated with comprehension as well as one section of the Apraxia Battery for Adults (Slavin & Fabus, 2018.)  Aphasia, Apraxia; Adults https://clinicalprosody.wordpress.com/2019/10/09/slavin-fabus-2018/ 

_______________________________________________________

GESTURING OUTCOMES

________________________________________________________

Limited Evidence

  • This case study described a case in which a woman with aphasia and apraxia profited from the addition of singing into her therapy programming when traditional therapy had failed. Evidence of progress took the form of improved performance on the gestural portion of the Profile of Communicative Ability (Keith & Aronson, 1974.) Apraxia, Aphasia; Adults https://clinicalprosody.wordpress.com/2016/09/30/1340 
  • The authors provide objectives and strategies for clinicians wishing to include music in their treatment of children in the early stages of communication development. They report marked increase in purposeful reaching for objects (Witt & Steele, 1984.) Developmental Delay; Children https://clinicalprosody.wordpress.com/2016/10/13/witt-steele-1984/

Evidence contraindicates the use of the intervention for the specific outcome(s)

____________________________________________________

IMITATION OUTCOMES

______________________________________________________

Strong Evidence

Moderate Evidence

  • This Systematic Review (SR) with broad criteria is concerned with a variety of treatments and outcomes. The authors of the SR rated sources for quality of certainty of results. The source that targeted imitation performance on the PICAC was rated as Preponderant (Murray et al., 2014.) Childhood Apraxia of Speech; Children https://wordpress.com/post/clinicalprosody.wordpress.com/1329

Fair Evidence

Limited Evidence

  • This single case study investigated the effect of an adapted form of Melodic Intonation Therapy (AMIT) on a patient (P) with Broca’s Aphasia who was a speaker of Brazilian Portuguese. The investigators monitored 73 outcomes. The outcomes associated with imitation improved (da Fontoura et al., 2014.) Aphasia, Adults https://clinicalprosody.wordpress.com/2016/12/05/da-fontoura-et-al-2014/
  • This is a case study of a patient diagnosed with aphasia and apraxia 10 years prior to the investigation. The results reveal that a modified version of Melodic Intonation Therapy was successful in improving an outcome associated with comprehension as well as one measures of repetition (Slavin & Fabus, 2018.)  Aphasia, Apraxia; Adults  https://clinicalprosody.wordpress.com/2019/10/09/slavin-fabus-2018/

Minimal Evidence

  • This program description with associated case studies is an example of early work (1974) supporting the view that music can play a role in intervention with children with developmental delays. The author described positive changes (but not documentary evidence of progress) in imitation (Brown, 1974.) Developmental Delay; Children https://clinicalprosody.wordpress.com/2016/04/23/brown-1974/

Contraindicated

  • Overall results of 2 Experiments involved French children diagnosed with reading impairments treated with Cognitive-Musical Training (CMT) indicated no significant improvement in repetition of nonsense words or of digits (Habib et al., 2016.) Literacy Problems; Children  https://clinicalprosody.wordpress.com/2017/03/12/habib-et-al-2016/

______________________________________________________________

INITIATION OF SPEAKING TURNS/CONVERSATION OUTCOMES

______________________________________________________________

Strong Evidence

  • This prospective, randomized group design with controls investigation supports the effectiveness of the Lee Silverman Voice Treatment (LSVT) and respiration-based (R) therapy in improving initiation of conversation, monotonicity, hoarseness, intelligibility (Ramig et al., 1995.)   Parkinson’s Disease; Adult https://clinicalprosody.wordpress.com/2014/02/04/ramig-et-al-1995/

Moderate Evidence

Fair Evidence

________________________________________________________

INTELLIGIBILITY OUTCOMES

_______________________________________________________

Strong Evidence

  • Comparisons of Face-to-face (FTF) and Online versions of Lee Silverman Voice Treatment (LVST) revealed that both FTF and Online interventions resulted in similar changes in several some measures of intelligibility (i.e., perceived ease of understanding and reduced requests for repetitions.) Moreover, there were no significant differences between the Online and FTF versions of LVST (Theodoros et al., 2016.) Parkinson’s Disease; Adults  https://clinicalprosody.wordpress.com/2017/02/11/theodoros-et-al-2016/

Moderate Evidence

  • This single subject experimental design investigation reports that Lee Silverman Voice Treatment improves speaker intelligibility (Fox & Baulk, 2012.)  Cerebral Palsy; Children https://clinicalprosody.wordpress.com/2013/08/25/fox-boliek-2012
  • This research provides moderate support for a computer-based intervention for moderate to strong improvement of intelligibility on the Computerized Assessment of Intelligibility (Thomas-Stonell et al., 1991.) Neurological Impairment; Children, Adolescent https://clinicalprosody.wordpress.com/2013/05/19/thomas-stonell-et-al-1991
  • Short term therapy based on Halliday (1970) with and without visual feedback results in improvements in intelligibility ratings by SLPs. Only the interventions with the visual feedback yields improvements in physician’s ratings of intelligibility (Scott & Caird, 1983.) Parkinson’s Disease; Adults https://clinicalprosody.wordpress.com/?s=Scott+%26+Caird+%281983%29
  • This single group pre-post test intervention experiment yielded results supporting the effectiveness of Lee Silverman Voice Treatment (LVST) in improving intelligibility. Overall, intelligibility significantly improved following LVST and analyses of effectiveness for individuals revealed that 6 of the 8 participants improved significantly (Cannito et al., 2012.) Parkinson’s disease; Adults  https://clinicalprosody.wordpress.com/2016/12/30/cannito-et-al-2012/ 

Fair Evidence

  • In this learning (i.e., not intervention) research, this investigation revealed that any one of 4 computerized rate control strategies could result in improved sentence intelligibility although metered approaches and additive rhythmic approaches seemed better than the cued rhythmic approach (Yorkston et al., 1990.) Parkinson’s Disease, Dysarthria—Ataxic; Dysarthria—Hypokinetic; Adults  https://clinicalprosody.wordpress.com/2015/01/04/yorkston-et-al-1990/

 Limited Evidence

  • Three case studies suggest that Lee Silverman Voice Treatment has variable effectiveness in increasing overall intelligibility (Countryman et al., 1994.) Parkinsonian Plus Syndromes; Adult https://clinicalprosody.wordpress.com/?s=Countryman
  • This case study reported improvement in the perception of intelligibility following Combination Treatment which involves Lee Silverman Voice Treatment (LSVT) plus Respiration therapy and Physical therapy but not with LSVT alone (Solomon et al., 2001). Traumatic Brain Injury, Hypokinetic- spastic dysarthria; Adult  https://clinicalprosody.wordpress.com/2014/04/23/solomom-et-al-2001
  • Case studies provide limited and inconsistent support of intonation intervention for improving intelligibility. However, the investigators have an interesting definition of intelligibility (Grube et al., 1986.) Speech Sound Disorders, Intelligibility Problems; Children https://clinicalprosody.wordpress.com/2013/06/02/grube-et-al-1986/
  • The evidence from these case studies inconsistently support the use of delayed auditory feedback (DAF) as a compensatory device to improve intelligibility in reading and conversation. The changes do not generalize to speech when the DAF is not worn (Hanson & Metter, 1983.) Parkinson’s Disease; Adult https://clinicalprosody.wordpress.com/?s=Hanson
  • These case studies provide promising information that music therapy with concurrent speech-language therapy can result in limited improvement in intelligibility on the Sentence Intelligibility Test and strong improvement in intelligibility in spontaneous speech (Tamplin, 2008.) Dysarthria; Adult, Adolescent https://clinicalprosody.wordpress.com/2013/06/14/tamplin-2008/
  • The results of this case study suggest a combined intervention (Lee Silverman Voice Treatment and the Ryan Fluency Program) was moderately successful in improving intelligibility in a boxer with ataxic dysarthria. However, the patient’s self-perception of his communication skills decreased markedly (McMicken et al., 2011). Ataxic Dysarthria; Adult https://clinicalprosody.wordpress.com/2014/08/16/mcmicken-et-al-2011/
  • These case studies suggest that a systems approach has variable potential to improve intelligibility of single words but not connected speech (Pennington et al, 2006.) Cerebral Palsy, Dysarthria; Children, Adolescent https://clinicalprosody.wordpress.com/2013/09/03/pennington-et-al-2006/
  • Three case studies suggest that Lee Silverman Voice Treatment has variable and limited effectiveness in improving intelligibility of single words (Countryman et al., 1994.) Parkinsonian Plus Syndromes; Adult https://clinicalprosody.wordpress.com/?s=Countryman
  • This traditional narrative review provides a guide to incorporating Lee Silverman Voice Treatment (LVST-Loud) into telepractice and reviews research documenting its effectiveness for intelligibility as well as its costs and P satisfaction (Theodoros & Ramig, 2011) Parkinson’s Disease; Adults https://clinicalprosody.wordpress.com/2014/05/23/theodoros-ramig-2011
  • This case study of an Iranian patient (P) describes the speech characteristics of Wilson’s disease. The investigators also describe a two-year course of treatment that that they claimed resulted improved intelligibility (Farazi et al., 2018.) Dysarthria (Wilson’s Disease); Adults https://clinicalprosody.wordpress.com/2020/10/20/farai-et-al-2018/

Minimal Evidence

No Evidence Provided

Not Graded

  • Both metered and patterned rhythmic speech resulted in improved word accuracy in this clinically related research. Neither form of rhythmic speech cueing was more effective. However, both forms of rhythmic cueing were most effective with Ps who were classified as severely impaired speakers and the optimum rate of speech was the habitual speaking rate or 60% of habitual speaking rate (Thaut et al., 2001.) Parkinson’s Disease; Adults https://clinicalprosody.wordpress.com/2016/07/07/thaut-et-al-2001/

Contraindicated

__________________________________________________________

INTERACTION OUTCOMES

_________________________________________________________

Strong Evidence

  • MT (melodic therapy) yielded significantly better outcomes of discourse informativeness than other MIT adaptations using rhythm only (RT) or spoken words only (ST.) All 3 interventions (MT, RT, ST) resulted in significant improvements in the imitation of trained words but improvement with untrained words was consistently better with MT than with RT or ST. None of the interventions resulted in improved measures of diadochokinetic rate or of mood (Zumbansen et al., 2014.) Broca’s Aphasia; Adults https://clinicalprosody.wordpress.com/2016/03/16/zumbasen-et-al-2014/

Moderate Evidence

Fair Evidence

Limited Evidence

  • This program description with associated case studies is an example of early work (1974) supporting the view that music can play a role in intervention with children with developmental delays. The author described positive changes (but not documentary evidence of progress) in early communication/interaction skills (Brown, 1974.) Developmental Delay; Children https://clinicalprosody.wordpress.com/2016/04/23/brown-1974/
  • This descriptive case study describes a music therapy based intervention in which by following the child’s lead he was able to help the child establish a link between the child’s actions and the music played by the music therapist and eventually establish eye contact and beginning forms of interpersonal communication (Saperston, 1973). Autism Spectrum Disorders, Developmental Delay; Child https://clinicalprosody.wordpress.com/2015/01/13/saperston-1973/

Minimal Evidence 

  • This program description with associated case studies is an example of early work (1974) supporting the view that music can play a role in intervention with children with developmental delays. The author described positive changes (but not documentary evidence of progress) in early communication/interaction skills (Brown, 1974.) Developmental Delay; Children https://clinicalprosody.wordpress.com/2016/04/23/brown-1974/ 

__________________________________________________________

LANGUAGE DEVELOPMENT –GENERAL OUTCOMES

__________________________________________________________

Fair Evidence

•  This research revealed that performance on the CELF P2 did not improve significantly following the intervention (Staples et al., 2009.)  Childhood Apraxia of Speech; Children.  https://clinicalprosody.wordpress.com/2019/01/17/staples-et-al-2009/ 

Limited Evidence

_________________________________________________________

LITERACY OUTCOMES

_________________________________________________________

Moderate Evidence

  • The results of 3 single subject experimental design investigations indicate that Interactive Metronome training paired with traditional training does not result in improved reading fluency in children (Lewis, 2015.) Literacy problems, Reading Fluency problems; Children https://clinicalprosody.wordpress.com/2016/02/20/lewis-2015/

Moderate Evidence

  • Moderate improvement in comprehension of read stories, as assessed using a cued recall, during expressive storybook reading. Not an intervention study but is clinically related (Mira & Schwanenflugel, 2013.) Typically Developing; Children https://clinicalprosody.wordpress.com/2013/12/27/592/

Fair Evidence

  • The number of incorrectly read words improved significantly following a prosody-based reading-rate acceleration program (Pinto & Navas, 2011.)   Literacy (Typically Developing); Children https://clinicalprosody.wordpress.com/2018/01/07/pinto-navas-2011/
  • This research presents support for the improvement on the Syllable Segmentation subtest of the Preschool and Primary Inventory of Phonological Awareness (PIPA) (Staples et al., 2009.) Childhood Apraxia of Speech; Children. https://clinicalprosody.wordpress.com/2019/01/17/staples-et-al-2009/ 
  • The application of Reader’s Theatre yielded improved reading fluency (number of words read per minute) in elementary school-aged children. The children’s perception of their reading and the participation in work groups also improved. Some of the measures were composite measures in which prosodic behaviors such as rate, affective prosody, loudness, phrasing, continuity, and rhythm comprised a portion of the score (Kelly, 2015).  Literacy Problems; Children  https://clinicalprosody.wordpress.com/2019/11/06/kelly-2015/
  • This single group investigation revealed that a comprehension-based Readers Theatre intervention for 2nd graders who are English Language Learners can improve timing (phrasing), intonation, and stress (i.e., fluency) of oral reading (Daly, 2009). Literacy (fluency), ELL; Children https://clinicalprosody.wordpress.com/2014/06/02/daly-2009/

Limited Evidence

  • This case study described a case in which a woman with aphasia and apraxia profited from the addition of singing into her therapy programming when traditional therapy had failed. Evidence of progress took the form of improved performance on the graphic portion of the Profile of Communicative Ability (Keith & Aronson, 1974.) Apraxia, Aphasia; Adults https://clinicalprosody.wordpress.com/2016/09/30/1340
  • One P received traditional MIT and 3 Ps received a modification of MIT. Individual Ps’ change in graphic PICA scores ranged from no to moderate improvement (Marshall & Holtzapple, 1978.) Aphasia, Apraxia; Adults   https://clinicalprosody.wordpress.com/2016/10/31/marshall-holtzapple-1978/
  • This single case study investigated the effect of an adapted form of Melodic Intonation Therapy (AMIT) on a patient (P) with Broca’s Aphasia who was a speaker of Brazilian Portuguese. The investigators monitored 73 outcomes. The outcomes associated with literacy tended to improve (da Fontoura et al., 2014.) Aphasia, Adults https://clinicalprosody.wordpress.com/2016/12/05/da-fontoura-et-al-2014/
  • This case study describes music therapy designed for a child with Childhood Apraxia of Speech. The investigator noted that child displayed increased knowledge of some letters and their associated sounds (Bearthard & Krout, 2008.) Childhood Apraxia of Speech; Children https://clinicalprosody.wordpress.com/2017/04/14/beathard-krout-2008/

Minimal Evidence

  • The authors reviewed Diliberto et al.’s English Accenting Patterns as a strategy focusing on teaching students to identify and read multisyllabic words using appropriate lexical stress. Students who received this intervention out performed a control group (Heggie & Wade-Woolley, 2017.) Literacy; Children clinicalprosody.wordpress.com/2017/08/30/heggie-wade-woolley-2017/

No Intervention Evidence Provided 

  • This expert opinion presents evidence from the literature that dysfluent reading may be associated with teacher behaviors. Although the focus of the teaching strategies was dysfluent reading, these strategies could be helpful with prosodic problems (Allington, 2006.) Literacy problems; Children, Adolescent https://clinicalprosody.wordpress.com/2014/03/16/allington-2006/
  • This blog post briefly describes activities that speech language pathologists (SLPs) can use to integrate prosody into interventions for children with Childhood Apraxia of Speech (CAS.)  Some of the activities include music (Stoeckel, 2016.)  Childhood Apraxia of Speech; Children  https://clinicalprosody.wordpress.com/2018/08/14/stoeckel-2016/ 
  • Tune in™ to Reading (TITR) is a music based interactive software program. The author of this expert opinion reviewed the literature and selected aspects of the program and noted that TITR has potential to treat children with cochlear implants (CI) (Eier, 2013.) Deafness, Hearing Loss, Cochlear Implants; Children https://clinicalprosody.wordpress.com/2015/10/31/eier-2013/

Evidence Contraindicates Use

  • The results of 3 single subject experimental design investigations indicate that Interactive Metronome training paired with traditional training does not result in improved reading fluency in children (Lewis, 2015.) Literacy problems, Reading Fluency problems; Children https://clinicalprosody.wordpress.com/2016/02/20/lewis-2015/

________________________________________________________

MEMORY OUTCOMES

_______________________________________________________

Moderate Evidence

Fair Evidence

Limited Evidence

  • This single case study investigated the effect of an adapted form of Melodic Intonation Therapy (AMIT) on a patient (P) with Broca’s Aphasia who was a speaker of Brazilian Portuguese. The investigators monitored 73 outcomes. The outcomes associated with memory tended to improve (da Fontoura et al., 2014.) Aphasia, Adults https://clinicalprosody.wordpress.com/2016/12/05/da-fontoura-et-al-2014/ 

________________________________________________________

MLU/WORDS PER MINUTE OUTCOMES

________________________________________________________

 Moderate Evidence

  • This Systematic Review (SR) with broad criteria is concerned with a variety of treatments and outcomes. The authors of the SR rated sources for quality of certainty of results. The source that targeted MLU was rated as Suggestive (Murray et al., 2014.) Childhood Apraxia of Speech; Children https://wordpress.com/post/clinicalprosody.wordpress.com/1329

Fair Evidence

  • Investigators reviewed music therapy (MT) sessions describing the effectiveness of 7 MT techniques for improving prosody. Overall, gains from the 12 session course of treatment for the fluency outcome ranged from minimal to moderate (Kim & Tomaino, 2008.) Nonfluent Aphasia; Adults https://clinicalprosody.wordpress.com/2018/01/29/kim-tomaino-2008/

Limited Evidence

  • These case studies provide limited support for using Melodic Intonation Therapy (MIT) as a warm-up prior to traditional therapy session to increase sentence length and complexity (Krauss & Galloway, 1982.) Expressive Language Delay and Childhood Apraxia of Speech; Child https://clinicalprosody.wordpress.com/2013/06/23/krauss-galloway-1982/
  •  Case studies provide limited and inconsistent support of intonation intervention for improving perceived length of utterance (Grube et al., 1986.) Intelligibility Problems; Speech Sound Disorders; Child https://clinicalprosody.wordpress.com/2013/06/02/grube-et-al-1986/
  • This is a case study of a patient diagnosed with aphasia and apraxia 10 years prior to the investigation. The results reveal that a modified version of Melodic Intonation Therapy was successful in improving an outcome associated with comprehension as well as increased mean length of utterance, MLU (Slavin & Fabus, 2018.)  Aphasia, Apraxia; Adults    https://clinicalprosody.wordpress.com/2019/10/09/slavin-fabus-2018/ 
  • Illustrative case studies provide variable support for the use of modified melodic intonation (MIT) therapy in conjunction with other speech therapies to increase sentence length and complexity (Helfrich-Miller, 1994.) Childhood Apraxia of Speech; Child https://clinicalprosody.wordpress.com/2013/10/27/helfrich-miller-1994/

Evidence ContraIndicates Use

_________________________________________________________

MOTOR OUTCOMES (nonspeech)

_______________________________________________________

Fair Evidence, minus

  • Investigators reviewed music therapy (MT) sessions describing the effectiveness of 7 MT techniques for improving prosody. Overall, gains from the 12 session course of treatment for the breath support outcome ranged from minimal to moderate (Kim & Tomaino, 2008.) Nonfluent Aphasia; Adults https://clinicalprosody.wordpress.com/2018/01/29/kim-tomaino-2008/

Not graded (clinically related, not intervention research)

 

Contraindicated

_______________________________________________________

MORPHOSYNTAX OUTCOMES

______________________________________________________

Limited Evidence, plus

Limited Evidence, minus

Evidence Contraindicates The Use Of The Intervention For The Specific Outcomes 

 

__________________________________________________________

NARRATION (Story Telling/Retelling)

_________________________________________________________

Moderate Evidence, plus

____________________________________________________

NORMALCY/NATURALNESS OUTCOMES

___________________________________________________

Moderate Evidence

 

Fair Evidence, plus

  • These case studies provide variable support for an intervention to improve contrastive stress, voice quality (pitch and loudness), articulatory precision, and naturalness but not verbal repairing (Hartelius et al., 1997.) Multiple Sclerosis; Adult https://clinicalprosody.wordpress.com/?s=Hartelius

Limited Evidence

Minimal Evidence

  • These case studies yielded minimally applicable clinical results because the sessions were very brief. The perceptual measures of abnormality decreased following both interventions: Lee Silverman Voice Treatment and intonation only therapy (Kobayashi et al., 2004.) Dysarthria; Adult https://clinicalprosody.wordpress.com/2013/11/13/kobayashi-et-al-2004/

Contraindicated

  • In this learning (i.e., not intervention) research, this investigation revealed that both metered and rhythmic computerized rate control strategies resulted in decreased speech naturalness rating for Ps with hypokinetic dysarthria. For the Ps with hypokinetic dysarthria, naturalness rating improved with rhythmic approached and decreased with metered approaches (Yorkston et al., 1990.) Parkinson’s Disease, Dysarthria—Ataxic; Dysarthria—Hypokinetic; Adults https://clinicalprosody.wordpress.com/2015/01/04/yorkston-et-al-1990/

____________________________________________________

ON-TASK BEHAVIOR OUTCOMES

_____________________________________________________

Fair Evidence

_________________________________________________

ORAL MOTOR SKILL OUTCOMES

–––––––––––––––––––––––––––––––––––––––––––––––––

Strong Evidence, minus

 

Limited Evidence, plus

  • This case study reported improvement in some measures of breathing following Lee Silverman Voice Treatment (LSVT) and Combination Treatment which involves LSVT plus Respiration therapy and Physical therapy (Solomon et al., 2001). Traumatic Brain Injury, Hypokinetic- spastic dysarthria; Adult https://clinicalprosody.wordpress.com/2014/04/23/solomom-et-al-2001

Limited Evidence

  • The results of this case study suggest a combined intervention (Lee Silverman Voice Treatment and the Ryan Fluency Program) was moderately successful in improving diadokokenesis skills in a boxer with ataxic dysarthria. However, the patient’s self-perception of his communication skills decreased markedly (McMicken et al., 2011). Ataxic Dysarthria; Adult https://clinicalprosody.wordpress.com/2014/08/16/mcmicken-et-al-2011/

Minimal Evidence

  • This case illustration provides limited support for the use of an intervention using music (rhythm, melody/pitch) to improve responses to tongue exercised speech in an adult with apraxia and aphasia following a cerebral vascular accident (Rogers & Fleming, 1981.) Apraxia, Aphasia; Adults https://clinicalprosody.wordpress.com/2015/09/30/rogers-fleming-1981/

Evidence Contraindicates The Use Of The Intervention For The Specific Outcomes

 

__________________________________________________________

PHONOLOGY/PHONOLOGICAL PROCESSES OUTCOMES*

*(see also Articulation/Speech Sound Outcomes)

__________________________________________________________

Strong Evidence, minus

Fair Evidence, plus

  • Spanish language dominant Mexican American children suppressed syllable deletion as the result of the traditional phonological process (PP) therapy as well as music-based (phonological process (MT) therapy. There was some evidence suggesting that the children who receive MT therapy progressed more rapidly than the PP therapy (Crutchfield, 2014.) Speech Sound Disorder, Phonological Process Disorder; Children https://clinicalprosody.wordpress.com/2016/05/21/crutch-field-2104/

 

Fair Evidence, minus

Limited Evidence

 

___________________________________________________

PICTURE DESCRIPTION OUTCOMES

__________________________________________________

Fair Evidence, plus

__________________________________________________

POINTING OUTCOMES

__________________________________________________

Moderate Evidence

Limited Evidence, plus

_____________________________________________________

PRAGMATIC OUTCOMES

_____________________________________________________

Moderate Evidence

Moderate Evidence, minus

  • Computer-assisted technologies have potential to improve comprehension of prosodic affect and sarcasm/metaphors in individuals with autism spectrum disorders (ASD) but it is not clear that it is more effective than conventional interventions (Ploog et al., 2013.) Autism Spectrum Disorders, Asperger Syndrome; Children https://clinicalprosody.wordpress.com/2016/03/28/ploog-et-al-2013/

Fair Evidence, plus

Fair Evidence, minus

Limited Evidence

  • This is a case study of a patient diagnosed with aphasia and apraxia 10 years prior to the investigation. The results reveal that a modified version of Melodic Intonation Therapy was successful in changing the use of different sentence types over time (Slavin & Fabus, 2018.)  Aphasia, Apraxia; Adults    https://clinicalprosody.wordpress.com/2019/10/09/slavin-fabus-2018/ 

Limited Evidence, minus

  • The authors explained the rationale for co-treatment of communication disorders by music therapists (MT) and speech-language pathologists (SLP) and described the strategy using a single case. The dependent measure was classroom engagement (Geist et al., 2008). Language Impairment; Children https://clinicalprosody.wordpress.com/2014/05/14/geist-et-al-2008/

______________________________________________________

PRODUCTION OF PHRASES OUTCOMES

______________________________________________________

Moderate Evidence, minus

  • This investigation demonstrates the effectiveness music therapy in improving production of simple sentences in developmentally delayed children from Taiwan who were speakers of Mandarin Chinese (Lee, 2008). Speech Impairment, Language Impairment; Children https://clinicalprosody.wordpress.com/2014/07/23/lee-2008/

 

  • This is a case study of a patient diagnosed with aphasia and apraxia 10 years prior to the investigation. The results reveal that a modified version of Melodic Intonation Therapy was successful in improving an outcome associated with comprehension as well as increasing the number of utterances (Slavin & Fabus, 2018.)  Aphasia, Apraxia; Adults  https://clinicalprosody.wordpress.com/2019/10/09/slavin-fabus-2018/

Fair Evidence, plus

  •  The critically reviewed source reported immediate (within a week of the termination of therapy) improvement in production of trained sentences  for both Melodic Intonation Therapy (MIT) and Rhythmic Therapy (RT.)  However, exploration of maintenance indicated MIT was superior to RT (Watson, 2106.)  Aphasia (nonfluent); Adults https://clinicalprosody.wordpress.com/2018/07/25/watson-2016/

No Evidence Provided

  • This blog post briefly describes activities that speech language pathologists (SLPs) can use to integrate prosody into interventions for children with Childhood Apraxia of Speech (CAS.)  Some of the activities include music (Stoeckel, 2016.)  Childhood Apraxia of Speech; Children  https://clinicalprosody.wordpress.com/2018/08/14/stoeckel-2016/

____________________________________________________

PRODUCTION OF WORDS OUTCOMES

_____________________________________________________

Moderate Evidence

 

Moderate Evidence, minus

  • This Systematic Review (SR) with broad criteria is concerned with a variety of treatments and outcomes. The authors of the SR rated sources for quality of certainty of results. The source that targeted naming performance on the PICAC was rated as Preponderant (Murray et al., 2014.) Childhood Apraxia of Speech; Children https://wordpress.com/post/clinicalprosody.wordpress.com/132
  • This investigation demonstrates the effectiveness music therapy in improving production of single words in developmentally delayed children from Taiwan who were speakers of Mandarin Chinese (Lee, 2008). Speech Impairment, Language Impairment, Developmental Delay; Children https://clinicalprosody.wordpress.com/2014/07/23/lee-2008/

Fair Evidence, plus

 

Fair Evidence

 

Limited Evidence, plus

  • These case studies provide limited support for using Melodic Intonation Therapy (MIT) as a warm-up prior to traditional therapy session to improve performance on some subtests of Porch Index of Communicative Ability in Children (PICAC), naming of items, increased sentence length and complexity, and increased intelligibility (Krauss & Galloway, 1982.) Expressive Language Delay and Childhood Apraxia of Speech; Children https://clinicalprosody.wordpress.com/2013/06/23/krauss-galloway-1982/

 

No Evidence Provided

  • This blog post briefly describes activities that speech language pathologists (SLPs) can use to integrate prosody into interventions for children with Childhood Apraxia of Speech (CAS.)  Some of the activities include music (Stoeckel, 2016.)  Childhood Apraxia of Speech; Children  https://clinicalprosody.wordpress.com/2018/08/14/stoeckel-2016/ 

Ineffective

  • The results of this small group investigation suggest that a music-based intervention to improve expressive language in preschool children was not successful in improving expressive vocabulary scores (Hoskins, 1988). Cognitive Impairment, Developmental Delay; Children-preschool https://clinicalprosody.wordpress.com/2015/10/16/hoskins-1988/

____________________________________________________

PSYCHOLOGICAL STATUS OUTCOMES

_____________________________________________________

Strong Evidence, minus

 

Moderate Evidence, plus

Fair Evidence, plus

Limited Evidence

  • The results of 3 single subject experimental design investigations indicate that Interactive Metronome training paired with traditional training does not result in improved reading fluency in children (Lewis, 2015.) Literacy problems, Reading Fluency problems; Children    https://clinicalprosody.wordpress.com/2016/02/20/lewis-2015/

Evidence Contraindicates Use

––––––––––––––––––––––––––––––––––––––––––––––––––––

RATE OF VERBALIZATION OUTCOMES

–––––––––––––––––––––––––––––––––––––––––––––––––––––

Moderate Evidence

Fair Evidence

___________________________________________________

REPETITIVENESS OUTCOMES

__________________________________________________

Fair Evidence, plus

Limited Evidence

  • This is a case study of a patient diagnosed with aphasia and apraxia 10 years prior to the investigation. The results reveal that a modified version of Melodic Intonation Therapy was successful in improving an outcome associated with comprehension as well as one measures of repetition (Slavin & Fabus, 2018.)  Aphasia, Apraxia; Adults  https://clinicalprosody.wordpress.com/2019/10/09/slavin-fabus-2018/

Minimal Evidence

___________________________________________________

RESONANCE OUTCOMES

______________________________________________

Fair Evidence, minus

Evidence contraindicates the use of the intervention for the specific outcome(s)

No Intervention Evidence Provided

  •  This article provides recommendations for treating voice and communication problems associated with transmasculine voices. The author highlights aspects of communication that may be a challenge to speakers and provides recommendations for treatment. In addition, the author a clear rationale for speech-language pathologists (SLPs) to provide services to speakers with transmasculine voices (Block, 2017.) Transgender voice; Adult https://clinicalprosody.wordpress.com/2018/05/21/block-2017/

___________________________________________

RESPIRATION OUTCOMES

__________________________________________

Fair Evidence, minus

–––––––––––––––––––––––––––––––––––––––––––––––––––––––

RESPONDING TO QUESTIONS/COMMANDS OUTCOMES

_________________________________________________________

Moderate Evidence

Fair Evidence, plus

Limited Evidence 

  • The authors provide objectives and strategies for clinicians wishing to include music in their treatment of children in the early stages of communication development. They report a limited increase in responding to their names (Witt & Steele, 1984.) Developmental Delay; Children https://clinicalprosody.wordpress.com/2016/10/13/witt-steele-1984/

Limited Evidence, minus

_________________________________________________________

SEMANTICS OUTCOMES

––––––––––––––––––––––––––––––––––––––––––––––––––––––––

Moderate Plus Evidence

  • Both Song and Nonsong treatments were effective in teaching vocabulary comprehension to school-aged Iranian English language learners. However, Song and Nonsong group outcomes were not significantly different from one another at the post intervention testing (Akbarpour & Roohani, 2015.) English Language Learners; Children https://clinicalprosody.wordpress.com/2016/11/11/akbarpour-roohani-2015/

Moderate Evidence

  • This single-subject experimental design investigation revealed that there was no change in the proportion of conversational nouns, verbs, adjectives/adverbs, and function words as the result of the drug Bromocriptine (Raymer et al., 2001.)   Aphasia, Crossed Nonfluent Aphasia; Adult https://clinicalprosody.wordpress.com/2015/09/09/raymer-et-al-2001/

Fair Evidence, plus

  • Second-grade English language learners were treated with one of four story-based interventions that compared music versus speech as a presentation strategy and illustrations versus no illustrations as extralinguistic support. There were no significant differences in receptive vocabulary score sbetween music versus speech and the illustration versus no illustration contexts suggesting that music based stories yield gains similar to speech-based stories (Medina, 1990.) Second Language Learners; Children https://clinicalprosody.wordpress.com/2017/12/27/medina-1990/

Fair Evidence, minus

Limited Evidence

  • This is a case study of a patient diagnosed with aphasia and apraxia 10 years prior to the investigation. The results reveal that a modified version of Melodic Intonation Therapy was successful in improving an outcome associated with comprehension as well as reducing the type token ratio  (Slavin & Fabus, 2018.Aphasia, Apraxia; Adultshttps://clinicalprosody.wordpress.com/2019/10/09/slavin-fabus-2018/

No Treatment Evidence Provided

 

_____________________________________________

SINGING OUTCOMES

______________________________________________

Fair Evidence, plus

No Intervention Data Provided

  •  This article provides recommendations for treating voice and communication problems associated with transmasculine voices. The author highlights aspects of communication that may be a challenge to speakers and provides recommendations for treatment. In addition, the author a clear rationale for speech-language pathologists (SLPs) to provide services to speakers with transmasculine voices (Block, 2017.) Transgender voice; Adult https://clinicalprosody.wordpress.com/2018/05/21/block-2017/

______________________________________________

SOCIAL INTERACTION OUTCOMES

_______________________________________________

Fair Evidence, plus

Limited Evidence, minus

____________________________________

TURN TAKING OUTCOMES

____________________________________

Moderate Evidence, plus

Fair Evidence, plus

Limited Evidence, minus

__________________________________________

VERBAL EXPRESSION OUTCOMES

__________________________________________

Moderate Evidence, minus

  • This review investigated the reasons for using music therapy (MT) for improving communication development of children (ages 0 to 8 years)  diagnosed with Autism Spectrum Disorder (ASD). One of the uses of MT was to improve expressive language (i.e., the production of speech and language  (Vaiouli & Andrews, 2018.Autism Spectrum Disorder; Children  https://clinicalprosody.wordpress.com/2019/02/13/vaiouli-andrews-2018/

Fair Evidence, plus

Limited Evidence, plus

  • This case study described a case in which a woman with aphasia and apraxia profited from the addition of singing into her therapy programming when traditional therapy had failed. Evidence of progress took the form of improved performance on the verbal portion of the Profile of Communicative Ability (Keith & Aronson, 1974.) Apraxia, Aphasia; Adults https://clinicalprosody.wordpress.com/2016/09/30/1340

Limited Evidence

  • Only a portion of this comprehensive intervention involved using prosody outcomes to treat speech production outcome. The intervention was moderately effective yielded moderate progress with respect to speech production (Ertmer et al. 2002.) Hearing Loss, Cochlear Implants; Children https://clinicalprosody.wordpress.com/2016/01/26/ertmer-et-al-2002/

Minimal Evidence

  • This case illustration provides limited support for the use of an intervention using music (rhythm, melody/pitch) to improve automatic speech, vowels, progressively more complex jargon, and confrontation naming in an adult with apraxia and aphasia following a cerebral vascular accident (Rogers & Fleming, 1981.) Apraxia, Aphasia; Adults https://clinicalprosody.wordpress.com/2015/09/30/rogers-fleming-1981/

No Evidence Provided

__________________________________________

VERBAL REPAIRING OUTCOMES

___________________________________________

Evidence contraindicates the use of the intervention for the specific outcome

––––––––––––––––––––––––––––––––––––––––––––––––––

 VOCALIZATION/VERBALIZATION OUTCOMES

–––––––––––––––––––––––––––––––––––––––––––––––––––

Moderate Evidence

Moderate Evidence, minus

  • This investigation demonstrates the effectiveness music therapy in improving attention in developmentally delayed children from Taiwan who were speakers of Mandarin Chinese (Lee, 2008). Speech Impairment, Language Impairment, Developmental Delay; Children https://clinicalprosody.wordpress.com/2014/07/23/lee-2008/

Fair Evidence, plus

Limited Evidence

 

  • This program description with associated case studies is an example of early work (1974) supporting the view that music can play a role in intervention with children with developmental delays. The author described positive changes (but not documentary evidence of progress) in pre-speech vocalizations (Brown, 1974.) Developmental Delay; Children   https://clinicalprosody.wordpress.com/2016/04/23/brown-1974/

Limited Evidence, minus

–––––––––––––––––––––––––––––––––––––––––––––

VOICE QUALITY OUTCOMES

__________________________________________________

Strong Evidence, minus

 

Moderate Evidence

 

Fair Evidence, minus

  • Boys with muscle tension dysphonia (MTD) received an intervention focusing on awareness, relaxation, breathing, phonation, and homework. The results of this retrospective, descriptive, single group investigation revealed progress several aspects of voice quality and in the reduction of hypercontraction (Lee & Son, 2005.) Voice Quality, Muscle Tension Dysphonia; Children https://clinicalprosody.wordpress.com/2015/12/07/lee-son-2005/
  • This single, small group investigation with pre-and post-intervention testing revealed that some of the targeted outcomes improved significantly following 6 weeks of intervention (1 hour per week). The perceptions of breathiness and severity improved from pre- to post- testing (Solberg, 2019).  Parkinson’s disease; Adults https://clinicalprosody.wordpress.com/2020/04/15/solberg-2019/

Fair Evidence

  • The investigators explored the changes in fundamental frequency, pitch range, voice quality, and perceptions of effectiveness of hormone therapy administered to transgender males. Although there was individual variation, overall participants tended to produce lower pitch levels indicating a deepening of their voices (Hancock et al., 2017.) Transgender maies; adults clinicalprosody.wordpress.com/2017/12/12/hancock-et-al-2017/
  • Single case studies were used to explore the efficacy of Lee Silverman Voice Treatment (LSVT) for improving voice quality of 2 patients with vocal fold atrophy and bowing that accompanied with aging (i.e., presbyphonia). The investigation revealed significant and/or marked improvement in almost all of the voice quality and laryngeal structure related outcomes  (Lu et al., 2013.)  Voice Quality, Prebyphonia; Adult  https://clinicalprosody.wordpress.com/2019/09/07/lu-et-al-2013/

Limited Evidence, plus

Limited Evidence

  • This preliminary report suggests that a computer game that presents acoustic feedback has some promise in reducing pitch breaks and modulating pitch range (Hoque et al., 2009.) Autism Spectrum Disorder; Adolescent https://clinicalprosody.wordpress.com/?s=Hoque

 

  • This case study reported limited improvement in perception of voice quality/vocal press following Lee Silverman Voice Treatment (LSVT) and not for Combination Treatment which involves LSVT plus Respiration therapy and Physical therapy (Solomon et al., 2001). Traumatic Brain Injury, Hypokinetic- spastic dysarthria; Adult https://clinicalprosody.wordpress.com/2014/04/23/solomom-et-al-2001

Limited Evidence, minus

  • This case study of an Iranian patient (P) describes the speech characteristics of Wilson’s disease. The investigators also describe a two-year course of treatment that that they claimed resulted improved voice quality (Farazi et al., 2018.) Dysarthria (Wilson’s Disease); Adults https://clinicalprosody.wordpress.com/2020/10/20/farai-et-al-2018/ 
  • This traditional narrative review provides a guide to incorporating Lee Silverman Voice Treatment (LVST-Loud) into telepractice and reviews research documenting its effectiveness for breathiness and overall voice quality as well as its costs and P satisfaction (Theodoros & Ramig, 2011) Parkinson’s Disease; Adults https://clinicalprosody.wordpress.com/2014/05/23/theodoros-ramig-2011

 

Minimal Evidence

  • These case studies yielded minimally applicable clinical results because the sessions were very brief. The perceptual measures of voice quality improved following both interventions—Lee Silverman Voice Treatment and intonation only therapy (Kobayashi et al., 2004.)  Dysarthria; Adult https://clinicalprosody.wordpress.com/2013/11/13/kobayashi-et-al-2004/

No Evidence Provided

  • Although the purpose of this article was to initiate the development of a taxonomy of voice therapy treatment procedures, readers can use this article as a source for treatments of prosodic targets (Van Stan et al., 2015). Voice Disorders, Adults. 
  • This blog post briefly describes activities that speech language pathologists (SLPs) can use to integrate prosody into interventions for children with Childhood Apraxia of Speech (CAS.)  Some of the activities include music (Stoeckel, 2016.)  Childhood Apraxia of Speech; Children  https://clinicalprosody.wordpress.com/2018/08/14/stoeckel-2016/ 

Evidence Does Not Support Use

  • This case study failed to observe improvement in perceived vocal roughness following Lee Silverman Voice Treatment (LSVT) and Combination Treatment which involves LSVT plus Respiration therapy and Physical therapy (Solomon et al., 2001). Traumatic Brain Injury, Hypokinetic- spastic dysarthria; Adult https://clinicalprosody.wordpress.com/2014/04/23/solomom-et-al-2001

___________________________________________

VOICE ONSET TIME OUTCOMES

––––––––––––––––––––––––––––––––––––––––––––––

Moderate Evidence, plus

––––––––––––––––––––––––––––––––––––––––—–––––––––

 WORD/SOUND DISCRIMINATION OUTCOMES

_____________________________________________________

Fair Evidence, plus

Limited Evidence

  • This Narrative (or Traditional) review of the literature contains reviews of several investigations suggesting that the inclusion of music/singing in intervention directed toward discrimination can be associated with improvement (Michel & May, 1974.) General Language Impairment; Children https://clinicalprosody.wordpress.com/2016/04/27/michel-may-1974/

_______________________________________________

WORD FINDING OUTCOMES

_________________________________________________

Limited Evidence

 

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s

%d bloggers like this: